BWH Beats the Odds Again

One year ago, Dr. Anthony Spartos, 56, a family practice physician from Swampscott, arrived in the BWH Emergency Department with an extremely serious case and with long odds for survival. Today, Spartos is fully recovered and back to seeing his own patients, thanks in no small part to the life-saving, multidisciplinary efforts among the Departments of Emergency Medicine, Radiology, Cardiology, Neurology and Cardiac Surgery.

An Urgent SituationIt was a Friday evening, and Spartos had just joined his wife for a reception following a professional association meeting on Cape Cod. “From what I understand, I just collapsed,” said Spartos, who admittedly does not remember anything about the incident. He was immediately taken to the emergency department at Falmouth Hospital, where he was preliminarily thought to have suffered a major stroke. Requiring further tertiary care, Spartos was transferred to BWH.

“When Anthony first arrived, he was an extremely sick patient,” explained Charles Pozner, MD, BWH Department of Emergency Medicine, who was the attending physician in the ED that night. “He was quite unstable, requiring continuous resuscitative and diagnostic management.” Pozner and his fellow emergency physicians and nurses rapidly assembled the team necessary to make the correct diagnosis and to initiate life-saving treatment. And by 1 a.m., there were no less than seven attending-level BWH physicians from multiple disciplines caring for Spartos.

Diagnosing a Critical MysteryEmergency Radiology Division’s Stephen Ledbetter, MD, first performed and interpreted a CT scan. While the scans of Spartos’ brain were negative, ruling out the diagnosis of a stroke, a scan of his abdomen revealed a subtle abnormality, prompting the team to consider the possibility of a dissecting aortic aneurysm.

Lynne Warner Stevenson, MD, and Raymond Kwong, MD, of the Cardiovascular Division, were then called in, along with Robert Rizzo, MD, of the Department of Surgery, who has expertise in aortic aneurysms. Following a series of studies, a transesophageal echocardiogram revealed that Spartos was suffering from a type A aortic dissection. “Aortic dissection is a tear or partial tear in the lining of the largest blood vessel in the body, the aorta,” explained Kwong, who performed the echocardiogram. “This tear allows blood to penetrate the arterial wall. If the aorta ruptures, most people do not survive.”

The assembled team of physicians—including neurologist Farzaneh Sorond, MD, and cardiac surgeon Tom Mihaljevic, MD, who had since arrived on the scene—then determined that despite the severity of his condition, the only chance for survival was emergency surgery to replace his ascending aorta and part of his aortic arch.

“I remember the drawn faces of Anthony’s wife, children and friends in the waiting room as they learned that he might not recover, but that this high-risk, complex surgery was his best option,” said Stevenson.

A Happy EndingDespite the odds against him, Spartos’ surgery turned out to be a tremendous success, allowing for his complete recovery. “When I came to in the ICU, I literally had no idea what I had been through,” said Spartos, who was back to work seeing patients within six months of his surgery. “But I can tell you that I wouldn’t be here today if it weren’t for the physicians, who went to great lengths, working so hard to figure out what was wrong. The care I received at BWH was truly remarkable.”